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1
Aftercare Attendance Partially Moderated by
History of Physical Abuse and Gender Louise F.
Haynes1 Amy E. Herrin1 Rickey E. Carter1 Sudie
E. Back1 Robert L. Hubbard2 1Medical University
of South Carolina, Charleston, SC 2University
Medical Center, Clinical Research Institute, Duke
University, Durham, NC
Introduction
Results
Results
Figure 2 Odds Ratios 95 Confidence Intervals
for attending aftercare (N281) with regard to
gender and history of SA, after adjusting for
intervention group
Results The findings revealed that the odds of
attending aftercare were 1.91 times higher in
women than men (95 CI 1.2, 3.2 plt0.01)1.
Women were also more likely to report higher
rates of physical abuse (PA 78 women vs. 45
men, plt0.01) and sexual abuse (SA 67 women vs.
20 men, plt0.01). (Table 1) A significant
gender by PA interaction was found (plt0.01) but
no interaction between SA and gender (p0.68).
While the interaction between SA and gender was
not significant, the gender effect persisted
after adjustment for history of SA. For the PA
by gender interaction, women without PA were more
likely to return for aftercare when compared to
men with PA (OR12.25, plt0.01) or men without PA
(OR12.59, plt0.01) however, the odds of
aftercare for women with PA were one-tenth times
that of females without PA (OR0.1, plt0.01)
(Figure 3). Women with PA were no more likely to
attend aftercare than either males with (p0.27)
or without PA (p0.21). These results are
adjusted for the intervention group.
Introduction Substance use relapse rates are
often high in the first months after discharge
from inpatient substance abuse treatment, and
patient adherence to aftercare plans is often
low. Exposure to traumatic events is also high
among substance abuse patients and may affect
outcome. This secondary analysis examines the
relationship of participant gender on aftercare
attendance and the moderating effects of a
history of abuse.
Methods
Methods Four residential addiction treatment
centers participated in a NIDA-sponsored Clinical
Trials Network feasibility study designed to
estimate the efficacy of a post-discharge
telephone intervention intended to encourage
compliance with aftercare. Participants were 282
outpatients (100 women, 182 men) with substance
use disorders. In order to determine whether
prior physical abuse (PA) or sexual abuse (SA)
confounded the gender effect observed, separate
logistic regression models were used to test each
interaction. Study Design Four residential
treatment centers enrolled men and women 18 years
of age or older who voluntarily admitted to a
residential program for rehabilitation treatment,
not solely for detoxification Exclusion
Criteria current suicide intention or a recent
(lt 30 days prior to admission) suicide
attempt Subjects randomized into two groups
Telephone care group (TCG) and Standard care
group (SCG) After the follow-up visit, attempts
were made to verify the clients
attendance/participation in the assigned program
identified on the discharge plan. Verified
attendance was used as the primary outcome. This
differed from self-reported attendance. Statistic
al Analyses Separate logistic regression models
were used to test the interaction between gender
and history of SA and gender and history of PA to
see if previous SA or PA moderated the effect
that gender had on attending aftercare visits.
Figure 3 Odds ratios 95 Confidence Interval
for attending aftercare (N281) with regard to
gender and history of PA, after adjusting for
intervention group
Note In Figures 2 and 3, MMale, FFemale,
PAPhysical Abuse, NoPANo Physical Abuse,
SASexual Abuse, NoSANo Sexual Abuse
Conclusions
History of Sexual Abuse The gender effect of
aftercare attendance persisted after adjusting
for history of SA. Women were more likely to
attend aftercare than men, but there was no
statistical difference in attendance rates
between subjects with and without a history of
SA. History of Physical Abuse Women without a
history of PA were more likely to return for
aftercare visits than men with and without a
history of PA. The odds of attending aftercare
for women with a history of PA were 1/10 times
that of females without a history of PA.
Gender Women reported significantly more physical
and sexual abuse than men. Womens odds of
attendance were 1.91 times higher than the odds
of men attending aftercare. Individuals with the
lowest level of aftercare attendance were men,
and women with a history of PA. Interventions
to help increase aftercare attendance among men
and among women with a history of PA are
needed. In addition, future research to help
increase understanding of decreased participation
among men would be beneficial.
Figure 1 Percent of Males and Females who
reported PA or SA that attended aftercare
References
Acknowledgements
This study is funded by the following grants from
the National Institutes of Health DA0013727,
DA013711, DA013045, and DA013710. The consortium
performing this study was a part of the Clinical
Trials Network (CTN) established by the National
Institute on Drug Abuse (NIDA).

1. Haynes, L.F. Back, S.E. Leimberger, J.D.
   Hubbard, R.L. Improving the transition from
   residential to outpatient addiction treatment
   Gender differences in response to supportive
   telephone calls. In College on Problems of Drug
   Dependence Orlando, FL, 2005.